This government document is issued by Commission on Teacher Credentialing for use in California
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https://www.google.com/url?client=internal-element-cse&cx=001779225245372747843:zj4ggd3gpca&q=https://www.ctc.ca.gov/docs/default-source/educator-discipline/files/80303-notification-form.pdf%3Fsfvrsn%3Db7c353b1_4&sa=U&ved=2ahUKEwjM1ZGN4aryAhWOnYsKHYG3AS84UBAWMAh6BAgJEAE&usg=AOvVaw3-ejX98gUZZBsZRVZZD72O